John Fleming Insurance Agency
Vacation Trailer
Instructions: Please fill out the information below. Areas with an asterisk (*) need to be filled in.
Contact Information
Name*
Address
City
Postal Code
Email Address*
Telephone:*
Fax:
   
Detailed Quote Information
1. Type of Unit
2. Year Built
3. Trade Name
4. Model
5. Length
6. Serial Number
7. Deductible Required
8. Value of your Recreational Vehicle
9. Type of Coverage Required
10. Have you had any losses in the last 3 years?
If Yes, give details and claims amount paid by the insurance company
Comments